Signs and Symptoms of Head Lice

Not everyone with head lice will experience the same symptoms. However, the most common signs of a head lice infestation include:

1. Itchiness: Itchiness on the scalp, neck, or ears is a common symptom. This itching is often due to an allergic reaction to lice saliva or feces. For first-time infestations, itching may not begin until two to six weeks after exposure.

2. Trouble Sleeping: Head lice are more active at night, which can lead to difficulty falling asleep due to increased movement on the scalp.

3. Red Bumps or Sores: Infestations may lead to a rash or red bumps on the scalp, which can result in excessive scratching. This scratching can cause bacterial infections, manifesting as swollen lymph nodes, tender skin, and oozing sores. If an infection occurs, a physician may prescribe antibiotics for treatment.

4. Visible Nits: Nits (lice eggs) can indicate an active infestation. Look for oval-shaped, tiny nits about the size of a grain of sand, attached to the base of the hair shafts near the scalp. Nits can be challenging to spot as they may blend with the hair color. Empty or hatched nits may appear lighter and be easier to detect, while live nits might be yellow or whitish. They are often confused with dandruff or hair spray droplets.

5. Visible Nymphs or Lice: Both nymphs (young lice) and adult lice are small—nymphs are pinhead-sized, and adults are about the size of a sesame seed. They are commonly found on the scalp, around the ears, or at the base of the neck. Adult lice are usually tan or grayish-white but can appear darker in individuals with darker hair. They may also appear red if engorged with blood.

Causes of Head Lice

Head lice are spread primarily through close personal contact. They can also be transferred through sharing personal items such as combs, hats, or bedding. Head lice do not hop or fly but crawl from one person to another.